100例SARS患者外周血T淋巴细胞亚群分析

目的 :探讨SARS患者外周血T淋巴细胞亚群变化。方法 :采用流式细胞仪检测10 0例SARS住院患者外周血T淋巴细胞亚群。结果 :与正常组比较 ,SARS组白细胞总数显著下降 ,淋巴细胞百分数和绝对数显著下降 ,粒细胞绝对数显著下降 ,CD3 、CD4 、CD8 细胞绝对数显著下降 ,CD4 细胞百分数 ,CD8 细胞百分数及CD4 /CD8 比值差异无统计学意义。比较SARS患者各病程CD3 、CD4 、CD8 ,于病程第一至第三周较第四周下降明显 (P <0 .0 5 ) ,病程第一至第三周之间差别无显著性 (P >0 .0 5 ) ;结论 :SARS患者外周血T淋巴细胞亚群的变化对阐明SARS的发病机制有一定意义。     

梅毒患者外周血T淋巴细胞亚群及可溶性白介素2受体的变化及其临床意义

目的探讨梅毒患者外周血T淋巴细胞亚群及血清中可溶性白介素 2受体 (SIL 2R)水平及临床意义。方法应用流式细胞仪及酶联免疫吸附法测定 4 5例梅毒患者及其治疗后外周血的CD3 + 、CD4+ 、CD8+ 、CD4+ /CD8+ 比值及血清中SIL 2R水平。结果梅毒患者外周血CD4+ 、及CD4+ /CD8+ 比值明显低于正常对照组 ,而CD8+ 及血清SIL 2R水平则明显高于对照组 (P <0 .0 5 ) ,梅毒治愈后患者外周血CD4+ 、CD4+ /CD8+ 回升 ,而CD8+ 及血清SIL 2R则回落 ,与正常对照无显著性差异 (P >0 .0 5 )。结论本研究结果提示 ,活动期梅毒患者存在细胞免疫功能抑制现象 ,T淋巴细胞亚群及SIL 2R水平的测定对梅毒的病情及监测治疗效果有一定的参考价值     

肺癌和肺结核患者外周血T淋巴细胞亚群的检测

目的　为了探讨T淋巴细胞亚群在肺癌和肺结核发生中的变化 ,采用流式细胞术检测肺癌 3 0例 ,肺结核 2 5例 ,正常人 2 0例的外周血T淋巴细胞亚群。结果　肺癌组和肺结核组CD3、CD4、CD4/CD8比值均明显低于正常组 (P <0 .0 1) ,而CD8则高于正常组 (P <0 .0 1) ,但两组各项指标无显著性差异 (P >0 .0 5 )。结论　肺癌及肺结核患者免疫功能低下 ,T淋巴细胞亚群的检测对监控患者的免疫状态 ,指导临床治疗 ,观察疗效及预后有关重要的意义     

格林-巴利综合征患者T淋巴细胞亚群和TNFα含量测定

目的 :探讨血T淋巴细胞亚群及肿瘤坏死因子 (TNFα)水平与格林 巴利综合征 (GBS)的关系。方法 :采用APAAP、ELISA法对 2 2例GBS患者及 2 2例正常人进行外周血T淋巴细胞亚群及血清TNFα水平测定。结果 :重症GBS患者外周血CD+ 4显著高于对照组 (P <0 0 1) ,CD+ 4/CD+ 8比例增大 ,血清TNFα水平明显高于对照组 (P <0 0 1) ,重症组高于轻症组 (P <0 0 5 )。结论 :GBS患者的免疫功能处于失衡状态。外周血T淋巴细胞亚群及血清TNFα的测定 ,可直接反映患者的病情轻重。     

急性病毒性肝炎患者外周血T淋巴细胞亚群检测分析

目的 :了解急性甲、乙、丙型病毒性肝炎患者外周血T淋巴细胞亚群对疗效和预后判断的价值。方法 :用APAAP桥联酶标法检测 10 2例急性甲、乙、丙型病毒型肝炎患者外周血T淋巴细胞亚群CD3 、CD4、CD8、及CD4/CD8,并检测了 2 9例急性甲、乙、丙型病毒性肝炎患者治疗前后T淋巴细胞亚群变化。结果 :与正常对照相比 ,10 2例急性甲、乙、丙型病毒性肝炎患者外周血CD3 、CD4、CD4/CD8均有不同程度的降低 (P <0 . 0 5 ) ,而各型肝炎的CD8均显著增高 (P <0 . 0 1) ;2 9例患者治疗前后T淋巴细胞亚群比较 ,7例治疗效果差者 ,其CD4、CD4/CD8处于低水平而CD8始终处于高水平 (P >0 . 0 5 ) ,另 2 2例治疗效果较好者 ,各亚群指标均接近或恢复正常水平 (P <0 .0 5 )。结论 :急性甲、乙、丙型病毒性肝炎患者外周血T淋巴细胞亚群的改变是以CD4、CD4/CD8的降低 ,特别是CD8的显著增高为其特征 ,各亚群在治疗过程中的动态变化在一定程度上可能反映疾病的疗效及预后。治疗时 ,应注意调节机体的细胞免疫功能。     

甲状腺功能亢进患者外周血T淋巴细胞亚群的变化

目的　观察甲亢患者外周血T淋巴细胞亚群在甲亢治疗前后的变化。方法　用APAAP法测定甲亢患者治疗前和治疗后的T淋巴细胞亚群的CD2 ,CD4 ,CD8,并与正常对照组作比较。结果　甲亢患者的CD2 及CD4 水平明显降低 ,与正常对照组比较差异有非常显著性 (P <0 .0 1) ,经治疗后的CD2 ,CD4 则明显升高 ;CD8水平在甲亢患者治疗前后与正常对照组比较均无明显异常 ;CD4 /CD8在甲亢患者治疗前和治疗后则有显著意义 (P <0 .0 5 )。结论　T淋巴细胞亚群的检测对甲亢患者的诊断治疗和疗效的评价有一定的参考价值。     

再生障碍性贫血患者T淋巴细胞亚群与免疫球蛋白的变化及其临床意义

目的　探讨再生障碍性贫血 (再障 )患者T淋巴细胞亚群与免疫球蛋白的变化及其临床意义。方法　对 2 2例再障患者 (再障组 )进行外周血T淋巴细胞亚群及其血清免疫球蛋白检测 ,并与 18例门诊健康体检者 (对照组 )进行比较。结果　再障组CD+ 4 、CD+ 4 /CD+ 8、IgG、IgA、IgM水平比对照组明显降低 (P均 <0 .0 1) ,但CD+ 8明显升高 (P <0 .0 1) ;大部分患者CD+ 3 正常。再障组治疗后 15例有效 ,其IgG、IgA、IgM、CD+ 4 、CD+ 4 /CD+ 8比值升高至正常或接近正常 ,CD+ 8明显降低至正常或接近正常 ,与治疗前相比差异有显著性 (P <0 .0 1或 0 .0 5 )。结论　再障患者发病与免疫功能异常密切相关 ,不仅存在细胞免疫功能的异常 ,也存在着体液免疫功能的异常。用免疫抑制剂治疗有效者 ,T淋巴细胞亚群、免疫球蛋白水平可恢复正常或接近正常     

梅毒血清固定患者外周血T淋巴细胞亚群检测的意义

目的检测梅毒血清固定患者外周血T淋巴细胞亚群,为临床梅毒的早期治疗提供有效的治疗方法。方法用流式细胞仪检测梅毒血清固定患者外周血T淋巴细胞亚群CD3+、CD4+T、CD8+T细胞水平,分别分析CD3+CD4+及CD3+CD8+细胞在CD3+细胞中的比例。结果梅毒血清固定患者外周血T淋巴细胞亚群CD3+、CD8+T细胞水平分别为(67.42±8.17)%,(25.98±4.22)%,与健康对照组相比差异无统计学意义(t值分别为0.722和0.477,P均>0.05),CD4+T细胞、CD4+T/CD8+T比值分别为(33.58±6.95)%、(1.30±1.83),与健康对照组相比差异有统计学意义(t值分别为2.028和2.156,P均<0.05)。结论梅毒血清固定患者较健康人群的CD4+T细胞和CD4+/CD8+比值下降,提示梅毒血清固定患者存在免疫抑制现象。     

外周血淋巴细胞亚群变化在特发性血小板减少性紫癜中的意义

目的观察特发性血小板减少性紫癜(ITP)患者治疗前后外周血淋巴细胞亚群水平变化,评价其在ITP发病机制研究和治疗中的价值。方法利用流式细胞术检测ITP患者外周血淋巴细胞亚群(CD3 、CD3 CD4 、CD3 CD8 、CD19 、CD19 CD5 )水平。结果ITP组治疗前CD3 T淋巴细胞、CD3 CD4 T淋巴细胞百分率以及CD3 CD4 /CD3 CD8 比例减低,CD3 CD8 T淋巴细胞、CD19 B淋巴细胞、CD19 CD5 B淋巴细胞百分率均升高,与对照组相比较,差异有显著性(P<0.05)。ITP组治疗后,27例有效,9例无效。治疗有效组治疗后CD3 T淋巴细胞、CD3 CD4 T淋巴细胞百分率以及CD3 CD4 /CD3 CD8 比例升高,CD3 CD8 T淋巴细胞、CD19 B淋巴细胞、CD19 CD5 B淋巴细胞百分率均减低,与治疗前相比,差异有显著性(P<0.05),与健康对照组相比,差异无显著性(P>0.05);治疗无效组治疗后淋巴细胞亚群与治疗前相比,差异无显著性(P>0.05)。结论ITP患者外周血淋巴细胞亚群水平存在异常,可能与ITP患者体内细胞免疫和体液免疫紊乱有关,并在其中发挥重要的作用,治疗前后外周血淋巴细胞亚群水平的变化对于研究ITP发病机制以及观察ITP临床病情转归均起着一定的作用。     

41例肾综合征出血热患者细胞免疫变化的研究

目的　研究肾综合征出血热 (HFRS)患者外周血T细胞亚群的变化 ,以探讨其在HFRS发病中的作用。方法　应用流式细胞仪检测 4 1例HFRS患者外周血及 10例正常人外周血的T淋巴细胞 (CD3)、亚群CD4、CD8细胞的数量及CD4 /CD8比值。结果　HFRS患者病程中存在CD3、CD4、CD8细胞数量的不同程度升高 ,与对照组相比 ,CD3、CD8细胞数于发热期、低血压期、多尿期均显著高于对照组 (P <0 0 5或P <0 0 1) ;CD4细胞数于低血压期、少尿期明显增高 (P <0 0 1) ;CD4 /CD8比值下降 ,于发热期、低血压期、少尿期明显降低 ,与对照组相比差异有统计学意义 (P <0 0 5或 0 0 1) ;在HFRS不同病型中 ,随病型加重 ,CD3、CD4、CD8细胞数也随之增高 ,在重型达最高值 ,危重型患者略有下降。危重型患者显著升高的CD3细胞以CD8细胞为主 ,病情愈重 ,CD4 /CD8比值愈低。结论　T淋巴细胞亚群改变细胞免疫功能紊乱与HFRS发病密切相关     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.